Type 2 diabetes – what are the warning signs, and how can I reduce my risk?

From restless.co.uk

Diabetes is a major health challenge in the UK, affecting more than 5.8 million people. While type 2 diabetes accounts for roughly 90% of diagnosed cases, Diabetes UK warns that up to 1.3 million additional people may have the condition without knowing it.

Uncontrolled diabetes can come with serious complications – such as eye problems, nerve damage, and an increased risk of heart attack or stroke. So it’s important that it doesn’t go unchecked and untreated.

While this may sound daunting, try to remember that diabetes is usually manageable. Many people live long and healthy lives if the condition is handled properly. There are also several things that can prevent, and even reverse, its development.

Here, we’ll take a closer look at what type 2 diabetes is, the warning signs, and how you can reduce your risk.

What is type 2 diabetes?

Type 2 diabetes is a condition that most commonly occurs in people over 40. Those with the condition either don’t produce enough insulin or their bodies become resistant to it, preventing it from working effectively.

Insulin is a hormone that’s made in the pancreas. It acts like a key, allowing the carbohydrates we get from food and drink (which are broken down into glucose) to enter our cells, where they can be used as energy or stored as fat.

When insulin isn’t being used by the body properly, blood sugar levels can become too high (hyperglycaemia). Levels that remain high can damage blood vessels and lead to health complications, with the heart, eyes, feet, and kidneys affected most often.

Type 2 diabetes differs from type 1 diabetes, which is usually caused by an autoimmune reaction where the body mistakenly attacks itself, destroying the cells in the pancreas that make insulin. Type 1 diabetes often runs in families and is usually diagnosed before the age of 40.

What are the warning signs of type 2 diabetes?

Symptoms of type 2 diabetes might not always make you feel unwell, which is why many people can live with it for many years without realising.

However, according to health experts, if you have type 2 diabetes, you might find that you…

• Urinate more frequently, especially at night
• Struggle to satisfy your thirst, or feel thirsty all the time
• Have a dry mouth

• Feel more tired than usual

• Lose weight without trying to

• Experience blurred vision
• Take longer to heal after a cut
• Get regular bouts of thrush and/or itching in your penis or vagina

• Experience nerve pain, numbness, or tingling in your hands and/or feet

• Have dark patches on your armpits, neck, and groin areas (this is known as acanthosis nigricans and can be caused by excess insulin in the blood)

It’s important to visit your GP if you’re experiencing any of these symptoms, as the earlier diabetes is diagnosed and controlled, the lower your risk of developing long-term health complications.

Health complications of type 2 diabetes can include…

• Diabetic neuropathy (nerve damage)
• Heart attack and stroke due to damaged blood vessels

• Foot problems, such as ulcers and infections, due to poor circulation and nerve damage

• Kidney damage and/or disease (nephropathy)

• Gum disease (more sugar in your blood means more sugar in your saliva)
• The development of certain cancers

• Sexual problems due to restricted blood flow to the sexual organs

• Eye problems due to damage to the eye’s blood vessels (retinopathy)

To learn more about the health complications of type 2 diabetes, it’s worth reading this page from Diabetes UK.

How is type 2 diabetes diagnosed?

Type 2 diabetes can be easily diagnosed with a blood or urine test, which can be administered at your GP surgery or local health centre. Alternatively, you can pay a fee to do a test at home using an online service, such as Thriva.

Once you post off your sample, you should receive your results and a doctor’s report within 48 hours. If your blood sugar levels are raised, you’ll be advised to discuss the results with your GP.

If you have diabetes, your GP will talk to you about the best ways to control it, which usually involves medication, insulin therapy, and/or lifestyle adjustments.

You’ll also be required to monitor your blood sugar levels at home and attend regular check-ups with a doctor or nurse to make sure everything is under control.

To find out more about what happens after a type 2 diabetes diagnosis, head over to the NHS website. Or, if you’ve recently been diagnosed, you may find this page from Diabetes UK helpful.

What is prediabetes?

If your blood test tells you that your blood sugar levels are high but not high enough for a type 2 diabetes diagnosis, you might be told you have ‘prediabetes’ or ‘borderline diabetes’.

Prediabetes is an important stage in the development of diabetes, and by making some lifestyle adjustments, it’s possible to lower blood sugar levels and prevent it from progressing to type 2 diabetes.

To learn more about high blood sugar levels, have a read of this advice from the NHS.

However, it’s important to note that blood sugar levels can be interpreted differently based on a person’s individual circumstances. Your doctor will be able to confirm what your blood sugar levels should be.

Could I be at risk of developing type 2 diabetes?

As well as looking out for warning signs of type 2 diabetes, it’s important to know your risk, so you can be proactive in taking control of your lifestyle.

According to Diabetes UK, your risk of developing type 2 diabetes increases if you…

• Are overweight or obese (particularly if you carry a lot of extra weight around your midsection). Obesity is thought to account for 80-85% of the risk of developing type 2 diabetes.
• Are white and over the age of 40, or Black African, African-Caribbean, or South Asian and over the age of 25.

• Are a man (diabetes is slightly more common in men than women).

• Have a parent, sister, brother, or child with diabetes (two to six times more likely).
• Have Black African, African-Caribbean, or South Asian heritage (two to four times more likely).
• Have a history of high blood pressure.

If you’d like to find out your risk of developing type 2 diabetes, you can do so in just a few minutes using this tool on the Diabetes UK website. You’ll need to know your height, weight, and waist size before you get started.

Find out my risk

How can I reduce my risk of developing type 2 diabetes?

It’s estimated that there are over 13.6 million people with an increased risk of developing type 2 diabetes in the UK today.

However, if you think you’re at risk, there are ways to reduce it. In fact, Diabetes UK has highlighted that getting help from your GP can help cut your risk of type 2 diabetes in half.

The main ways to reduce your risk of developing type 2 diabetes are…

1. Make positive changes to your diet

While it might seem obvious, eating a healthy, balanced diet is one of the best things you can do to maintain a healthy weight and improve your overall health.

Small but beneficial steps you can take include…

Reducing your intake of simple sugars and refined carbohydrates

High intake of simple sugars and refined carbohydrates can contribute to weight gain. Simple sugars are also rapidly turned into glucose and absorbed into the bloodstream, causing blood sugar levels to rise quickly.

One of the best ways to reduce your intake of simple sugars and refined carbs is to limit processed foods in your diet (as they’re often high in fat, sugar, and empty calories) and eat more whole foods.

If you have a sweet tooth and would like tips on how to reduce your sugar intake, it’s worth reading our article: 9 simple ways to cut back on added sugar.

Eating smaller, more frequent meals

Eating smaller, more frequent meals can help regulate blood sugar levels.

A study of prediabetic men found that those who ate smaller portion sizes and adopted other healthy nutritional changes were 46% less likely to develop diabetes than men who made no changes to their eating habits.

For suggested portion sizes, check out this advice from The Association of UK Dietitians. Our article, 9 tips to prevent overeating and encourage portion control, also has some helpful tips.

Drinking more water

Staying hydrated helps your body remove excess glucose through urine. The NHS recommends drinking six to eight cups of fluid a day, with water being a top choice.

If you’re struggling to increase your water intake, you could consider investing in a water bottle with time markings* as a reminder to drink throughout the day.

Our articles, 10 tips for staying hydrated and 9 healthy and hydrating alternatives to water, offer more ideas.

Following a low-carb diet

Following a low-carb diet can be effective at keeping blood sugar levels low and stable because carbohydrates raise them more than any other food group.

Check out our article, 8 tasty and filling low-carb meals, for inspiration.

Eating more fibre

Increasing your fibre intake can help you maintain a healthy weight, reduce blood cholesterol levels, and improve gut health.

The government advises that adults should eat 30g of fibre a day – yet most people eat far less.

For tips on increasing your fibre intake, take a look at our article: 10 easy ways to add more fibre to your diet.

Getting enough vitamin D

Studies have shown that vitamin D can help lower blood sugar levels and decrease the risk of type 2 diabetes.

To make sure you’re getting enough, check out our article: What is vitamin D and why do we need it to stay healthy?

Cutting down on alcohol

Heavy drinking can interfere with blood sugar control and lead to weight gain, which can increase type 2 diabetes risk.

Diabetes UK advises that the safest way to enjoy a drink and keep your risk of developing type 2 diabetes to a minimum is to stick to the NHS alcohol guidelines.

You’ll find plenty more healthy diet tips in our diet and nutrition section.

2. Be more active

Exercise can help reduce your risk of developing type 2 diabetes in multiple ways.

Not only can it help you maintain a healthy weight, but it can also increase the body’s sensitivity to insulin, so it can be used more effectively – helping to keep blood sugar levels stable.

Plus, studies have shown that, alongside helping prevent diabetes, staying active may play a role in reversing it.

If you’d like to start taking small steps toward being more active, it’s worth reading our article: 17 creative ways to increase your daily step count. And, for more ideas and inspiration, head to our fitness and exercise section.

3. Get support to lose weight if you need it

The NHS recommends taking some steps towards losing weight if your BMI is 25 or above.

However, while we all know that eating a healthy diet and being active are good for us, losing weight can be easier said than done. So there’s nothing wrong with reaching out for support if you’re struggling to lose weight on your own.

One way you can do so is by joining a weight loss support group. If you’re looking for a place to start, the NHS has a lists several useful weight loss plans on their website. Your GP will also be able to advise you on the best ways to lose weight based on your individual health needs.

You could consider asking friends and family for help, too – perhaps by asking them to exercise with you and support you in making healthy meal choices.

4. Try to cut down on smoking

The risk of developing type 2 diabetes increases with the number of cigarettes you smoke. For example, one study showed that women who smoked more than 40 cigarettes a day were 74% more likely to develop diabetes, while men had a 45% increased risk. This is backed up by a 2018 population-based study that shows a link between cigarette smoking and pancreatic cell function.

Nicotine in cigarettes can make the body less sensitive to insulin, affecting how well it can use it. This causes both glucose and insulin levels to rise, which can develop into type 2 diabetes over time.

If you’re looking to give up smoking but are concerned about how you might do this, it’s worth chatting with your GP, who will be able to advise you based on your individual circumstances.

For more advice, check out our article: 7 tips for quitting smoking.

Final thoughts…

Considering our risk of developing certain health conditions can be daunting. However, it can be an important first step in making some positive lifestyle changes and taking control of our health.

If you’re aware that you need to make some lifestyle adjustments and are feeling overwhelmed, it can help to start small. Often, small changes come together to make a big difference and will be more sustainable in the long term.

It’s also key to be kind to yourself when working on your health, and give yourself credit for any positive changes you make, however small they might seem.

For more information, support, and advice, you can visit the Diabetes UK website. You might also like to read our article: 12 science-backed ways to lower (or regulate) blood sugar levels in our diet and nutrition section.

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5 Supplements You Shouldn't Be Taking If You Have Diabetes, According to a Dietitian

From eatingwell.com

Can supplements help with diabetes? Learn about five supplements you should consider avoiding if you have diabetes 

KEY POINTS 

• Lifestyle factors and sometimes medications are essential for healthy diabetes management.
• Avoid supplementing chromium, bitter melon, green tea extract, St. John's wort and vitamin E.
• Support healthy blood sugar with diet, physical activity, stress management and healthy sleep.

When it comes to diabetes, lifestyle plays a major role in blood sugar management and overall health. What you eat, how you move your body, your sleeping patterns and your stress levels are all factors that can impact blood sugar. Even if you are taking medications to manage your diabetes, they are to be used in conjunction with lifestyle strategies that include a nutritious eating plan, physical activity, managing stressors and getting healthy sleep. But what about supplements? Are they safe and effective?

Supplements are meant to fill nutrient gaps when you are unable to meet your needs through food alone or if you have a deficiency. Because supplements are not regulated by the Food and Drug Administration, it's important to take them cautiously. Always look for independently verified certification to ensure what they say is in it actually is, and never begin supplementation without supervision from a medical professional. Supplements can be costly and, if not taken carefully, may do harm, especially if you are taking certain medications or have other health conditions.

There are different types of diabetes and different treatment options for each type, so it's difficult to generalize which supplements all people with diabetes should not take. That's one of the reasons discussing your desires and questions with a knowledgeable medical professional is so important.

With that in mind, here are five supplements you may want to reconsider if you have diabetes, as they may interfere with certain medications, disrupt blood sugar levels or cause unwanted side effects.

1. Chromium

Chromium is a mineral found in a number of foods, such as meat, vegetables, grains, fruits and nuts. A deficiency in chromium may cause high blood sugar; however, deficiency is very rare. If you have diabetes and take insulin or other oral medications aimed to reduce blood sugar, taking chromium may increase the risk of hypoglycaemia (low blood sugar).

Anyone with kidney disease, which is a common complication of type 2 diabetes, should not take chromium because supplementation can worsen kidney disease. Chromium supplementation may also interfere with levothyroxine, a medication commonly used to treat hypothyroidism.

2. Bitter Melon

Bitter melon is an herbal supplement that has been studied for its use in reducing blood sugars in people with diabetes. Its components—charantin, vicine and polypeptide-p—are thought to have a similar structure to insulin, the hormone involved in blood sugar control.

Research on bitter melon supplementation is inconsistent. The studies that have been done are short, most are done on animals and the doses of bitter melon used vary. More research is needed to determine long-term effects and safety. In addition, bitter melon may increase your risk of low blood sugar.

3. Green Tea Extract

Drinking green tea has been shown to provide benefits for people with diabetes. However, there is little research on the effectiveness of a green tea supplement outside of studies conducted on animals, and most studies have been very short in duration. Therefore, additional supplementation beyond drinking green tea is probably not necessary. In addition, emerging research suggests that green tea supplements may have significant interactions with certain medications, reducing their effectiveness.

4. St John's Wort

More research is needed on the use of St. John's wort for diabetes, due to its potential effects on diabetes medications, insulin sensitivity and insulin secretion. One small study evaluated the use of St. John's wort and metformin in 20 healthy male subjects, and found that taking the two in conjunction can increase insulin secretion and lower blood sugar after a glucose tolerance test; however, the supplement decreased the clearance of metformin from the body. One review cautions against the use of St. John's wort for treatment of diabetes because of the potential of interference with drug metabolism.

Most studies on St. John's wort and diabetes have conflicting results, do not include diverse populations, used animal subjects or did not have a long enough duration to examine the long-term effects. Therefore, more studies are needed to explore the drug interactions and insulin secretion effects of St. John's wort.

5. Vitamin E

Vitamin E is a powerful antioxidant that can combat oxidative stress, a precursor and contributor to type 2 diabetes. Adequate dietary intake of vitamin E has been shown to protect against type 2 diabetes by helping reduce insulin resistance. However, high levels—such as those found in supplements—have not been shown to be useful. Also, vitamin E can interact with blood thinners and increase the risk for bleeding by blocking the clotting effects of vitamin K. Therefore, unsupervised supplementation is not recommended if you have diabetes and are taking blood thinners.

Tips for Healthy Eating If You Have Diabetes

Before spending lots of money on supplements that may not work or can cause harm, focus on making simple yet sustainable dietary changes. Here are a few to start with:

• Focus on whole foods: Whole foods contain a variety of macronutrients, vitamins and minerals. Aim to increase your intake of plants—fruits, vegetables, legumes, whole grains, nuts and seeds—that are rich in fiber, vitamins, minerals, antioxidants and healthy fats. Dairy, eggs, meats and seafood also provide essential nutrients, protein, and fat, which help stabilize blood sugar.
• Eat more fibre: Fibre is an indigestible part of carbohydrates that can help to reduce blood sugar spikes because it is metabolized slowly. Some simple ways to eat more fibre is to ingest one fruit or vegetable at each meal, make at least half of your grains whole grains and add one serving of unsalted nuts each day. The 2020-2025 Dietary Guidelines for Americans recommends consuming 25 to 38 grams of fibre daily. If you are not accustomed to eating fibrous foods, increase your intake slowly and drink ample amounts of fluids to reduce the risk of stomach discomfort, including gas and bloating.
• Pair your foods: When eating carbohydrates (grains, potatoes, beans, corn), pair them with non-starchy vegetables, lean protein and healthy fats. This food combination will not only provide satiating power, but also help provide steady energy and stable blood sugar. A simple yet effective strategy is to use the plate method: Fill half of your plate with non-starchy vegetables, one quarter with lean protein and the remaining quarter with a complex carbohydrate. For example, roasted chicken with stir-fried broccoli and baked sweet potato is a balanced and filling meal.

Our Expert Take

While supplements can serve a purpose when you need to fill nutrient gaps or when you are deficient, they are not always safe, and we often don't know their long-term effects. Before you spend money on supplements, take a look at your lifestyle. Eating a variety of fruits, vegetables, whole grains, nuts, seeds, lean protein and healthy fats can help you manage blood sugar and inflammation, a key factor in diabetes. Engaging in regular physical activity helps your body use the glucose in your food, promoting a healthy blood sugar. It's also important to get plenty of quality sleep and deal with what's stressing you out, as chronic stress has been linked with higher blood sugar levels.

If you have diabetes—or take care of someone who does—and don't know where to start, meet with a registered dietitian or certified diabetes care and education specialist. These medical professionals can answer all your questions about diabetes, including which supplements are safe to take and which ones should be avoided.

https://www.eatingwell.com/supplements-you-should-not-take-if-you-have-diabetes-11893520